PREventing Adverse Events Post-Discharge Through Proactive Identification, Multidisciplinary Communication, and Technology

NCT05232656 | Completed

• 1 other identifier: 2018P001137
• Study Type: interventional
• Target: 268
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this study is to expand the use of previously developed patient safety dashboards and patient-centered discharge checklists to three general medicine units in an affiliated community hospital. The safety dashboard and interactive pre-discharge checklist are cognitive aids for clinicians and patients, respectively, that serve to facilitate early detection of patients at risk for preventable harm, including suboptimal discharge preparation. The aims of this study are to:

1. 1.Enhance the safety dashboard and interactive pre-discharge checklist to include "smart" notifications for hospital-based clinicians when patients are at high risk for adverse events or have identified specific concerns related to discharge based on their checklist responses.
2. 2.Expand intervention to general medical units at our community hospital-affiliate, BWFH.
3. 3.Evaluate impact on post-discharge AEs for patients discharged from BWFH who are at risk for preventable harm and hospital readmission.

Conditions

Transitions of Care; General Medicine; Discharge Checklist; Adverse Event

Outcome Measures

Primary Outcomes (1)

• Potential Post-Discharge Adverse Events

  Potential post-discharge adverse events will be measured as the number of new or worsening symptoms or signs per patient

  24 months

Secondary Outcomes (2)

• Actual Post-Discharge Adverse Events

  24 months

• Preventable Post-Discharge Adverse Events

  24 months

Study Arms (2)

Pre-intervention

NO INTERVENTION

Usual care on three general medicine units. Patients/caregivers do no have access to the discharge preparation checklist. Providers do not have access to the safety dashboard.

Post-intervention

EXPERIMENTAL

Patients/caregivers have access to the pre-discharge preparation checklist. Providers have access to patient safety dashboard.

Behavioral: Pre-Discharge Checklist and Patient Safety Dashboard

Interventions

Pre-Discharge Checklist and Patient Safety Dashboard BEHAVIORAL

Pre-discharge preparation checklist for patients to assess discharge readiness. Patient safety dashboard for clinicians to proactively identify at-risk patients.

Post-intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Male or female, \>18 years of age, English-speaking
• Caregivers \>18 years of age designated by patient or patient's healthcare proxy
• Two or more patient safety risk factors

You may not qualify if:

• \- Non-English speaking patients for whom we cannot identify an English-speaking healthcare proxy

Sponsors & Collaborators

• Brigham and Women's Hospital: lead
• Crico: collaborator

Study Sites (1)

Brigham and Women's Hospital

Boston, Massachusetts, 02115, United States

Location

Related Publications (1)

• Vasudevan A, Plombon S, Piniella N, Garber A, Malik M, O'Fallon E, Goyal A, Gershanik E, Kumar V, Fiskio J, Yoon C, Lipsitz SR, Schnipper JL, Dalal AK. Effect of digital tools to promote hospital quality and safety on adverse events after discharge. J Am Med Inform Assoc. 2024 Oct 1;31(10):2304-2314. doi: 10.1093/jamia/ocae176.

  PMID: 39013194 DERIVED

Study Officials

• Anuj K Dalal, MD

  Brigham and Women's Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associated Physician

Study Record Dates

• First Submitted: January 31, 2022
• First Posted: February 10, 2022
• Study Start: September 1, 2018
• Primary Completion: March 20, 2020
• Study Completion: September 30, 2020
• Last Updated: February 10, 2022

Record last verified: 2022-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)